Prosthetic management of atrophic rhinitis

Atrophic rhinitis is a form of chronic rhinitis in which the nasal mucosa atrophies and hardens, causing the nasal passages to dilate and dry out. Other prominent findings include bad smell, extensive nasal crusting and bleeding. Surgical and nonsurgical methods have been advocated for its treatment. We describe a prosthetic technique for its management     

A case report of esthesioneuroblastoma

Esthesioneuroblastoma (Olfactory Neuroblastoma) arises from the olfactory placode in the olfactory area of the nasal cavity. The age incidence ranges from 3 years to 79 years. It usually presents with nasal symptoms like obstructed nasal breathing and epistaxis. The diagnosis may be delayed for several months due to its slow growing nature. It may be misdiagnosed with other small round cell tumors. One such case is reported here due to its rare incidence, difficulty in early diagnosis and very aggressive behaviour compared to the reported series inspite of recommended treatment by different modalities.     

Endoscopic removal of malignant melanoma of the nasal cavity

Mucosal melanoma of the nasal cavity is a rare tumour. With the extended used of nasal endoscopes and advent of CT scan, early diagnosis of nasal melanoma and accurate assessment of its extent is possible. This allows endoscopic excision of tumour, avoiding unnecessary removal of healthy tissue. Here we present a case where endonasal endoscopic excision with postoperative radiotherapy achieved disease free survival till follow up (nearly 2 years).     

Parotid abscess — an unusual presentation with palatal palsy

A case of parotid abscess with ipsilateral palatal palsy leading to nasal intonation and nasal regurgitation is being reported on account of its unusual clinical presentation. The anatomical consideration explaining the involvement of the pharyngeal branch of vagus nerve is discussed with review of relevant available literature.     

结外鼻型NK/T细胞淋巴瘤的研究进展

结外鼻型NK／T细胞淋巴瘤是鼻腔淋巴瘤中较为常见、恶性程度高且预后较差的病种。因此．了解其发生发展、临床表现、病理诊断、治疗及预后是非常重要的。     

Extranodal natural killer/T-cell lymphoma, nasal type: epidemiology study

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKTCL) is a rarely kind of non-Hodgkin lymphoma (NHL). It is much more frequent in Asian and Latin American countries than other part of the world. It typically affects nasal cavity. In China, one of its endemically places, ENKTCL accounts for 74%–96% of nasal NHL. Patients with ENKTCL usually show a highly aggressive clinical course, and its etiology is unclear. However, it is already proved that ENKTCL is associated with Epstein-Barr virus (EBV) infection, regardless patients’, ethnicity and areas. Some studies show that the risk will increase among several occupations, such as farmer, who are frequently exposure to pesticides and chemical solvent and risk can be cut down if taking some protective measures.     

Primary nasal lymphoma,NK/T‐cell type: Report of two cases with similar presentation but different outcome

Two cases of natural killer (NK)/T‐cell primary nasal lymphoma with similar clinical presentations are reported, for comparison and contrast, to highlight the clinical issues and challenges posed by this unusual disease, its aggressiveness being matched only by its rarity. Presenting as a lesion in the nasal cavity with histological features of malignant lymphoma, primary nasal lymphoma is an uncommon extranodal lymphoma, which poses problems in both diagnosis and management. In people of oriental descent, the common cell subtype is NK/T‐cell. Although it is generally thought that combination treatment with chemotherapy and radiation is the best management for early stage non‐Hodgkin's lymphoma (NHL), there is still debate as to whether combined therapy is optimal treatment for this particular subtype of NHL, given that it responds less well to conventional chemotherapy. Herein we report two patients to illustrate these controversies.     

Atypical Presentations of Rhinosporidiosis: A Clinical Dilemma?

Rhinosporidiosis is a chronic inflammatory disease common in India and Sri Lanka. Its manifestations are mostly nasal, though extranasal ones in head and neck region are not rare. Occasionally these presentations lead to diagnostic dilemma. Here we present some cases with its associated confusions if any. In this study thirty five patients were included. Extranasal manifestations were noted in nine cases. Two patients attended with laryngopharyngeal and one with lacrimal sac presentation–subsequent nasal endoscopic examination revealed presence of nasal masses, too. Other six cases presented with polypoidal mass hanging from nasopharynx into oropharynx. One of them was confused with nasopharyngeal angiofibroma. Two laryngopharyngeal masses were removed successfully with rigid laryngoscope followed by cauterisation of the base. The solitary lacrimal sac mass was excised by external approach combined with nasal endoscope guided excision of nasal mass. The other six cases with nasopharyngeal attachment were subjected to nasal endoscope guided removal. In all these cases, the base of the lesions was cauterised. The experience about the various manifestations and diagnostic problems is discussed here.     

Myeloperoxydase Expression in The Pathogenesis of Nasal Polyps

Nasal polyps are benign mucosal protrusions that expand into the nasal cavity. There are no any etiological factors that may explain the pathogenesis of nasal polyps but currently inflammation continues to be the major factor. As a result of inflammation, neutrophils become activated and migrate to the inflammatory area and form their bactericidal effects by producing free oxygen radicals. The objective of our study is to investigate the expression of myeloperoxydase enzyme, which is usually an indicator of leukocyte infiltration and is responsible in the formation of free oxygen radicals in polyp tissues and to determine its role in the pathogenesis of nasal polyps.     

Meningioma in the nose

A case of primary intranasal meningioma located in right nasal cavity and eroding right ethmoid, medial wall and floor of right orbit and medial wall of right antrum is presented with a brief review of relevant literature. To our knowledge, it forms 34th case of its kind, in the series of primary meningioma of the nasal cavity and paranasal sinuses” and is amongst the very few to have occured in a child of just eight years. Both primary tumor and its recurrence are successfully removed by lateral rhinotomy.     

Transcutaneous Columellar Strut for Correcting Caudal Nasal Septal Deviation

Correction of caudal septal deviation is a challenging issue because of its significant role in tip support mechanisms. Some interventions especially aggressive resection of caudal septum to correct deviation, may compromise external nasal valve, tip ptosis and persistence of nasal obstruction. Many surgical techniques have been suggested to correct this type of nasal septal deviation. This study presents a technique to correct caudal septal deviation without weakening of tip support mechanisms. To evaluate the efficacy of insertion of a transcutaneous columellar strut during correction of caudal septal deviation. The study was performed in patients complaining from nasal obstruction with caudal septal deviation. After intranasal incision and elevation of mucoperichondrial flap, Caudal septum released from anterior nasal spine (ANS) and a band of cartilage removed from inferior and caudal part of septum and septum again fixed to ANS. Through a vertical transcutaneous incision, a cartilaginous strut is placed in columella, between medial crurae. Preoperative and postoperative NOSE score determined and photographs were taken. In 14 patients we performed this technique, the postoperative NOSE score showed significant improvement, (p?=?0.001). Nasal breathing improved in all patients without any complication or tip ptosis or worsening of nasal appearance. This septoplasty technique along with placement of transcolumellar strut, is an easy, efficient and complication free method for simultaneously correction of caudal deviation of nasal septum, reinforcing external nasal valve and prevents tip ptosis.     

Inverted Papilloma — An Unusual Presentation (Foreign-Body like)

Inverted papilloma of the nose is an uncommon, but, well document ed lesion of the mucosal lining of the nose and paranasal sinuses. The manifestation of this disease are usually unilateral nasal obstruction, mucopurulent nasal discharge, anosinia and occasional headache. It is very rare to she this condition presenting with dyspnoea and dysphagia due to its extension in the laryngopharynx. In this paper, we report a patient who presented to us with dyspnoea and dysphagia due to a huge papillomatous mass extending from right nasal cabity to the maxillary antrum laterally, posteriorly into the nasopharynx, interiorly into the oropharynx and the laryngopharynx.     

A study on the clinical profile and management of inverted Papilloma

Inverted Papilloma is a unique neoplasm characterized by its tendency to destroy bone, tendency to recur after incomplete removal and association with malignancy. The uncertainty of its clinical features and projected behaviour has resulted in an ill-defined approach to its management. This is a prospective study of 30 patients of Inverted Papilloma admitted at Regional Institute of Medical Sciences, Imphal between August 2001 to July 2003. In this study, meticulous attention is given to the clinical presentation and management in a series of 30 patients with inverted papilloma. A majority of patients were between 50–70 years (40%) with a mean age of 52.3 years. M: F Ratio=3.3:1. Commonest presenting symptoms were unilateral nasal obstruction (93.3%), nasal discharge (40%) and epistaxis (36.6%). 90% of the patients had signs of involvement of the nasal cavity with one or more sinuses and 46% showed bony erosion on C.T. Scan studies. Surgery was the treatment of choice in 90% of the cases.     

Non-Hodgkin's lymphoma confined to the nasal cavity: its relationship to the polymorphic reticulosis and results of radiation therapy

From 1975 through 1988, nine patients with locally confined nasal non-Hodgkin's lymphoma (NHL) were treated with radiation therapy in the Department of Radiology, Chiba University Hospital. Immunohistochemical study disclosed that all NHL's have T-lineage. Additionally, unique histological pictures of polymorphism, angiodestruction, and necrosis were seen in most of cases. These three findings are the histological features of polymorphic reticulosis (PMR), which is the main cause of lethal midline granuloma and has recently been shown to belong to T-cell malignancy. Therefore, it is concluded that the nasal T-cell NHL and PMR are really a single disease entity. The predominance of the T-cell lymphoma in the nasal cavity as well as its histological distinctness clearly indicate that the head and neck extranodal NHL cannot be discussed together. Although the disorder was considered to be locally limited at presentation, only 3 of the 9 patients with nasal NHL could be induced into long-term remission with involved field radiotherapy. The distant extranodal spread was the primary cause of failure. Multimodality treatment using intensive chemotherapy might improve the prognosis of nasal NHL.     

Survivin基因在鼻型NK/T细胞淋巴瘤的表达及与p53和bcl-2基因表达的关系

目的 :探讨Survivin基因在鼻型NK/T细胞淋巴瘤的表达及其与p5 3、bcl 2蛋白表达的相关性。方法 :应用免疫组织化学链霉素抗生物素蛋白 -过氧化酶连接法 (SP法 ) ,检测Survivin、p5 3、bcl 2基因在2 4例鼻型NK/T细胞淋巴瘤和 17例良性淋巴结病变中的表达。结果 :鼻型NK/T细胞淋巴瘤Survivin基因阳性表达率 4 5 8% ( 11/2 4 ) ,良性淋巴结病变Survivin基因阳性表达率 11 8% ( 2 /17) ,且主要局限于少数生发中心细胞 ,P <0 0 2 5。Survivin基因表达上调与p5 3高表达密切相关 ,P <0 0 5 ,但与bcl 2蛋白无明显相关性 ,P >0 0 5。结论 :Survivin基因的异常表达而引起的凋亡抑制可能在鼻型NK/T细胞淋巴瘤的发生进展中有一定的作用 ,且其与p5 3异常表达显著相关 ,但与bcl 2蛋白表达无明显相关性     

Effects of irradiation on nasal mucociliary clearance in head and neck cancer patients

A prospective longitudinal study was conducted on fifty patients of histopathologically confirmed head and neck cancer with the main aim to assess the nasal mucociliary clearance, pre-and post-irradiation; and to compare the findings with the healthy non-irradiated age and sex-matched controls. All the patients underwent saccharin particle test for nasal mucociliary clearance before commencement of radiation therapy and again within 6 months of completion of radiation therapy. The difference between the saccharin perception times of nasal mucosa in the healthy non-irradiated controls and the pre-irradiated head and neck cancer patients were statistically inssignificant (P>0.05). But, the difference between the saccharin perception times of nasal mucosa in the pre-and post-irradiated head and neck cancer patients was found to be statistically significant (P=0). It is concluded that even indirect irradiation of nasal mucosa in head and neck cancer patients significantly affect its ciliary activity. Significance of total radiation dosage along with chemotherapy in some cases was also studied.     

结外鼻型NK/T细胞淋巴瘤的临床病理特征及诊疗现状

结外鼻型NK/T细胞淋巴瘤是一种具有高度侵袭性的非霍奇金淋巴瘤。它与EB病毒感染密切相关,肿瘤细胞常浸润及破坏血管,提示其预后较差。病理学诊断是识别结外鼻型NK/T细胞淋巴瘤的主要方法,其镜下典型的特征为“洋葱皮样改变”,即以血管中心性的凝固性坏死和多种炎性细胞的混合浸润为特点。因其发病率不高,目前在治疗方面并无统一标准,但鉴于它具有恶性度高、侵袭性强、易复发和预后差等特点,近年来吸引了越来越多的研究者探索其发病机制和诊疗方案。     

A rare case of primary nasoethmoidal meningioma

Meningiomas of sinonasal tract is a rare entity especially in children. Primary sinonasal meningiomas often pose difficulty in diagnosis because of their infrequent occurrence and clinically they appear to be nasal polyp. The final diagnosis rests on the histological examination. Extra cranial meningiomas are rare in children and tend to be more aggressive. Here a case of primary ethmoid sinus meningoma with extension into the nasal cavity is presented and despite of its aggressive behavior it was benign. The importance of complete surgical extirpapion is undoubted and results in a good survival rate. Histological grading of the tumour is not crucial in predicting the rate of recurrence. The paucity of reported cases is the evidence for its rarity.     

鼻NK/T细胞淋巴瘤中BLU基因启动子区CpG岛甲基化状态研究

 目的 检测鼻NK／T细胞淋巴瘤中抑癌基因BLU启动子区CpG 岛甲基化的状况,并探讨其在鼻NK／T细胞淋巴瘤发生、发展中的作用及与临床病理特征的关系。方法 应用甲基化特异性PCR（methylation-specific PCR, MSP）技术,检测30例鼻NK／T细胞淋巴瘤、10例鼻咽淋巴组织增生中BLU 基因启动子区的甲基化状况;并应用原位杂交方法对30例鼻NK／T细胞淋巴瘤进行EB病毒检测。结果 30例鼻NK／T细胞淋巴瘤中有15例肿瘤组织BLU 基因启动子区CpG 岛发生异常甲基化,甲基化频率为50 %（15／30）,而10例鼻咽淋巴组织增生均无甲基化;EB病毒阳性组BLU 基因的甲基化频率与阴性组对比差异无统计学意义（P＞0.05）;BLU基因启动子区CpG 岛甲基化与临床病理特征之间均无统计学相关性（P＞0.05）。结论 在鼻NK／T细胞淋巴瘤中,抑癌基因BLU启动子区CpG 岛具有很高的甲基化频率,表明其在鼻NK／T细胞淋巴瘤的发生、发展中具有重要作用,并对肿瘤的早期诊断具有重要意义。